Emotional disturbance is a crisis situation which commands the attention of the community clergy. As the minister functions pastorally, several obvious factors may be borne in mind. First, the disturbed person is a child of God and a fellow human being. Second, he is experiencing an intense stress situation which may isolate him from himself, others, and God. Third, he may need to recognize his worth and preserve his dignity as a person. Fourth, he may be preoccupied with a way of meeting his needs and what he perceives as life’s demands. Fifth, he may need to become more aware of his God-given potential and realize the actualization of it.

Among mental health professionals it is generally agreed that the clergyman is a significant helping person. In the study, Americans View Their Mental Health,(Gerald Gerin, et. al., Americans View Their Mental Health [New York: Basic Books, 1960], pp. 305-7, 319.)it is reported 42 percent of persons who sought help turned to clergymen, 29 percent went to physicians, 18 percent to psychiatrists or psychologists, and 10 percent to social agencies or marriage clinics. This same report also reveals that of those who sought help 42 percent reported their problems centered around their marriage, 18 percent dealt with personal adjustment difficulties, and 12 percent related problems about their children. It is noted that 65 percent of those who sought assistance from clergymen claimed they received some help. These statistics indicate the significance of the pastoral function in emotional crisis and places upon the clergyman a heavy pastoral responsibility.

Chaplaincy Service in South Carolina State Hospital sponsored a study, "Chaplaincy-Community Clergy Developmental Project," ("Chaplaincy-Community Clergy Developmental Project," S.C. State Hospital Columbia. Mental Heath Project Grant OM-499, National Institute of Mental Health. Emily A. Spickler Program Consultant. J. Obert Kempson, Program Director.) for the purpose of exploring the contacts between mental patients and their churches and clergy in South Carolina, and of offering guidelines to assist community clergy in providing more meaningful pastoral care to mental patients upon their return home. The survey, by interview and questionnaire, explored interactions between pastors and patients before, during, and ‘after hospitalization. Information about the pastoral care skills used by the clergyman and his background was also secured. The social framework of the church as it related to the patient’s experience and the pastor’s outreach in helping the person were also data items.

Among the results secured from the study were several of particular interest. The number of patients in contact with both pastor and church before, during, and after hospitalization remained about the same. Overall, only a small portion of the patients had a long-term relationship with their pastors. Over half the patients of the 438 who supplied information had very little or no contact with their ministers. It was also noted that more than a third of former patients expressed discomfort about being present for or participating in the programs of the church, nor were they able to participate in community activities. About a third of the patients consciously sought help from their ministers. Lack of contact with their pastors or feelings about themselves or their pastors appeared to interfere with their attempts to seek help. Data revealed that 63 percent had never asked for pastoral help, that 27 percent had made no attempt at contact, that 12 percent were ashamed to seek help or felt the pastor would disapprove, and that 12 percent said he was unable to help.

About half the pastors of the 523 supplying data were providing pastoral care for disturbed persons who were not hospitalized, and about 40 percent said they were involved pastorally with hospitalized persons. These ministers were relating with disturbed persons in churches which were stable in membership, with regular worship and a moderate to full program each week.

The pastors’ initial contacts with the emotionally disturbed were ordinarily made by referral from others or because of the pastoral functions of the ministers. Half of clergy felt, as pastors, they must deal with persons’ religious and psychological needs together. The pastors recognized some lack of understanding existed between themselves and the community resources to which they might refer distressed persons. This matter of emotional distance was one of the areas which they felt was open for further exploration.

Some summary comments by Emily A. Spickler, who was Research Consultant of the project, are:

Protestant pastors of stable churches, less than 800 in membership, without special training in dealing with mental and emotional problems are in contact through their role as pastor with people inside and outside their churches who have mental and emotional problems. The goal of their pastoral activities is to help people develop a quality of relationship to God, man and self.

The ministers expressed the need for more available pastoral care resources. One-fourth of them desired help in the form of training for themselves, aid in methods of work or in preventive measures. The data revealed that pastors do not necessarily take on a new or unprecedented role in being concerned with emotionally distressed persons hospitalized or not hospitalized. Their pastoral care must take on a particular emphasis or extension in order to be effective with people who have special difficulties. Effectiveness in the pastoral role can be aided by understanding how the ill person’s reactions are affecting his contact with pastor and church, and in what areas pastoral methods and procedure can take this into account.

Another part of this particular survey reveals data which point up the clergyman’s functions as he ministers pastorally to emotionally distressed persons. This information was secured from interviews with forty-five pastors, fourteen patients, and two patient groups, one of which was followed over two months. The data describes several categories for pastoral care functioning.

The pastor can foster group-belonging which relates the distressed person to the church. This can be accomplished by the pastor’s maintaining his personal availability and also the availability of the church to people in distress. As several patients said, "We may not need to call on the pastor, but we know he is there. He is available twenty-four hours a day." Building a long-term relationship encourages confidence. This, in itself, would certainly discourage changes and interruptions in pastoral relationship. Fostering continuing contacts with disturbed persons who are unable to make these contacts themselves is a most important aspect of pastoral outreach. Church members also will need to be guided and instructed in making contacts. This kind of education for crisis pastoral care ministry would involve understanding about emotional distress, interpreting what the crisis situation is, preparing the members of the church in giving support, and maintaining relationship with the person in some way while in crisis and later.

The rehabilitation of the distressed person’s participation in the church comes through encouraging and supporting his responses. Acceptance provides an atmosphere for give and take between church groups and the person who may use the church as a family substitute. Furthermore, it is important sometimes that foster roles be provided these persons so as to avoid some of the intense conflicts which they have had in closer relationships with members of their families.

Another function focuses on pastoral care for the disturbed individual. In this supportive ministry the minister watches over the distressed person on a long-term basis but not in an overly solicitous manner, and cooperates with professionals in the treatment effort. The clergyman is available consistently regardless of how the patient responds or behaves. He listens to those who need to talk, and in particular to those who have no one else with whom to talk. Also he guides and interprets the uses of religious processes. Counseling can be provided persons who have expressed their concerns to the minister on levels where he is comfortable and possesses skill. Consultation from professionals can enhance his counseling. He refers, with pastoral skill, those whose situations are beyond his time and training. Sometimes distressed persons are unable to relate to other professionals. Here the minister has an opportunity to provide pastoral care to these persons. The clergyman can serve an important function by enabling the person to make more adequate community adjustments.

In providing for the pastoral care of the distressed person’s family the minister has an opportunity to help them understand their relationship to the person and something of the illness background. He can provide counsel in resolving guilt and in meeting their frustrations. The family needs to maintain hope instead of feeling that little can be done to help the person find a stable place in society again.

The minister guides and educates the membership of the church in understanding and dealing with mental and emotional illness. A long-term process of education needs to be undertaken in the average church to enable people to realize that in crisis they can turn to the pastor to secure help. The minister, representing God and the moral structure of the church, functions to help the family, the disturbed person, and the church understand the stress situation.

Preventive intervention in mental health may also be a facet of the minister’s educational and pastoral function. In his pastoral calling and other activities he can become aware of the need for providing the necessary counsel and guidance in order to prevent more serious trouble from developing. His sensitivity and concern can prompt him to enable the congregation to meet its pastoral care responsibilities as a redemptive community.

The pastor can provide first aid in crisis for both individuals and their families when, for varying reasons, they have been unable to contact or use community resources. Some persons recognize the minister’s availability on a twenty-four-hour basis for emergencies when other resources are unavailable. The minister may be perceived as the advocate of the poor, the dispossessed, and others who, not aware of community resources, need his counsel.

The effectiveness of the clergyman is influenced by his expectations, the expectations of others, the various demands on his time, and his own understanding and skill. His own church’s understanding of emotional illness will have a direct effect upon his efforts and how he functions pastorally. Most people see greater value in matters which the pastor and the church endorse. The minister is expected to be dependable, trustworthy, and to render no hurt. It is generally assumed that the pastor will not turn away from human need or seek to escape it. This places on him a great responsibility, a responsibility that needs to be shared with the total congregation as a caring community.

From the data supplied it becomes evident that a minister, to function more effectively with the emotionally disturbed, needs to formulate his concept of the pastoral function. Some guidelines are therefore suggested. The pastor, as a symbol of God and a symbol of the church, develops with a person a unique relationship characterized by understanding and acceptance of him as a child of God with potential which can be actualized. The pastor can assist in providing an atmosphere for the person to deal more adequately with his basic attitudes toward himself, man, the universe, and God through pastoral care (counseling, visiting, and group work) and worship experiences thereby enabling him to develop a more satisfactory style of life.

The several aspects of pastoral care for the emotionally disturbed described above set forth some principles and structure for the functioning of community clergy as they become involved with crises in the parish and in the community mental health setting. While the minister’s helping role in crisis is generally recognized by both professional and lay persons, he realizes his need for counsel and educational opportunities to develop his potential more fully. His desires, the expectations of his parishioners, and professional recognition stimulate cooperative endeavor on many levels by both religion and mental health leaders for crisis pastoral care intervention.

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